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im dr mulvar and i have the pleasure of introducing our speakers today adrian hernandez whos been on the faculty for i guess since what 2000 2002. i saw the light and came from texas to come help us here hes done a lot of health services research and actually um and really led the charge here on ascend hf our other speaker is craig reese whos a project leader in cardiovascular research and had the the task of keeping all the balls in the air and not having any of them crash and burn so theyre going to tell us about what it took to do ascend thank you all right uh well thanks um so its my pleasure today to talk about ascend and really for this audience wanted to talk about some of the issues we faced with ascend in terms of the concepts of pragmatic clinical trials uh certainly this group has heard a lot about importance or need for doing pragmatic clinical trials and we like to think that theyre calmly done but in reality thats uh actually turning out to be a very uncommon uh s